Allemann Pierre, Guarnero Valentine, Schoepfer Alain, Demartines Nicolas, Schäfer Markus
Service de chirurgie viscérale, CHUV, 1011 Lausanne.
Service de gastro-entérologie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2017 Jun 14;13(567):1248-1252.
Hiatal hernia is a frequent pathology. Two types have been described : sliding hernia and paraesophageal hernia (PEH). The first one is the most frequent and is associated with reflux disease. Patients with PEH have a large variety of symptoms, such as chest pain, dyspnea, regurgitation, iterative pneumonia and iron-deficiency anemia. Operative management is necessary for sliding hernia with reflux disease and for symptomatic PEH, respectively. In patients with asymptomatic PEH, operative risk must be balanced with the risk of postoperative complications. No specific operative technique has been validated so far as surgical standard. Several technical details are important and technique has to be adapted according to the size and type of hernia, preoperative symptoms and patient's comorbidities.
食管裂孔疝是一种常见的病症。已描述了两种类型：滑动性疝和食管旁疝（PEH）。前者最为常见，且与反流性疾病相关。PEH患者有多种症状，如胸痛、呼吸困难、反流、反复肺炎和缺铁性贫血。对于伴有反流性疾病的滑动性疝和有症状的PEH，分别需要进行手术治疗。对于无症状的PEH患者，必须权衡手术风险与术后并发症的风险。到目前为止，尚无特定的手术技术被确认为手术标准。几个技术细节很重要，并且必须根据疝的大小和类型、术前症状以及患者的合并症来调整技术。
